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Introduction: The aim of this study was to look if any clinical characteristics of oral aphthosis (OA) could discriminate Behcet’s Disease (BD) from Recurrent Aphthous Stomatitis (RAS), at the patient’s first visit.

Materials and Methods: In a prospective study, patients were enrolled in a case-control study as consecutive patients. BD was diagnosed by the International Criteria for Behcet's Disease (ICBD). RAS were people who had recurrent OA for four years or more, but not any other manifestations of BD. The following parameters were checked: age, age of onset, number of attacks, number of aphthosis per attack, healing time, and diameter of aphthosis, the most common sites and pain on a Likert scale, Pathergy test, and HLA-B51. Comparisons were made by Mann-Whitney U test (Z) and Pearson's chi square test (Chi2).

Results: Selected patients for the study were 200 BD and 194 RAS patients. The starting mean age, BD versus RAS was (23.0 vs. 21.9, p= 0.32), First visit mean age (31.4 vs. 33.2, p= 0.08). Males were (60% vs. 48%, p= 0.02). Pathergy test was (33% vs. 7%, p< 0.0001). There was no significant difference in the number of attacks, mean number of aphthosis per attack, and aphthosis diameters between the two groups by Mann-Whitney test. The healing time was longer in controls than in BD (Z=-3.129, p= 0.002). For HLA-B51 it was 36.8% vs. 21.7%, p= 0.001.

Conclusion: Not enough differences were found in clinical findings to differentiate BD-OA from RAS-OA. The main differences were gender, positive Pathergy, and HLA-B51.